Caminhos para construção de uma Política Nacional de Educação Permanente em Saúde no Brasil

Abstract

This article sought to point out the paths that led to the emergence of a National Policy for Permanent Health Education in the Lula's government. On one hand, we sought to configure the political construction that gave rise to the possibility of creating a Secretariat to deal with issues related to labor management and health education management. The creation of the Labor Management and Health Education Secretariat (SGTES) triggered the conceptual and political rupture with the field most identified to the debate on human resources in health. Within SGTES and more particularly the Department of Health Education Management (DEGES), the concept of permanent education in health (EPS) was raised for the first time to the condition of public policy. On the other hand, we also intended to show the conceptual construction around the EPS, initially taken from the territory of UNESCO, appropriated by OPAS and resigned by the United Network and the group that composed the first occupation of DEGES. In the Lula's government, SGTES was occupied by two groups at two different political moments. The first group was formed circumstantially and temporarily around the first Labor Management and Health Education Secretariat, Maria Luiza Jaeger, and was composed by her work team that came from the experiences of the democratic-popular government of Rio Grande do Sul, and by representatives of social movements among whom was the United Network and the Network of Popular Education and Health. The second group, which we call "human resources in health group" came from a long academic and political-institutional trajectory in the field of human resources in health, with an important reference in the performance of a wing of the health movement closer to "Partidão". The dividing line between the two moments of SGTES was the cession of the Health’s Ministry, which until then was under the command of the Workers' Party (PT) to the Brazilian Democratic Movement Party (PMDB), as an unfolding of the crisis of the monthly wage that hit the Lula's government. This process of occupation of SGTES was permeated by tensions and conflicts between these two groups and highlighted conceptual differences and political practice in the operationalization of the PNEPS, configuring distinct political proposals, arranged in two ordinances in the two periods of SGTES. In the first period, the Health Permanent Education Hubs were betting on a less institutional and more instituted action, by proposing a design that took the democratic idea in its radicality. In the second period, with the creation of the Teaching-Service Integration Commissions, we saw a more institutional bet of the EPS logic, whose proposal was adapted to the management design proposed in the Health Pact. The bets made by actors and actresses of both groups were influenced by their ways of conceiving and operating the Policy, as a result of their personal and collective experiences, experiences of historical process and political conjuncture, different insertions, world views, beliefs and ideologies. But they go beyond the PNEPS itself and reflect different ways of implementing SUS in Brazil.